Consumer perspectives of patient advocacy: a grounded theory
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2013-05
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University of Hawaii at Manoa
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Background: Patient advocacy remains conceptually ambiguous in the nursing literature. Research has been professionally dominated with few accounts of consumer beliefs and expectations of patient advocacy in the acute care hospital setting. Aim: The purpose of this study was to develop a substantive-level grounded theory focused in consumer perspectives of patient advocacy in order to advance the concept in nursing towards most effectively meeting nursing's responsibility to the public. Method: The grounded theory methodology of Corbin and Strauss (2008) guided the study. Findings: The core concept of Falling through the cracks of the system indicates that aspects of care described as patient advocacy by consumers, represented by the related concepts and processes of Being heard, Receiving information, and Participating, are missing or lacking, and a patient advocate is needed. Consumers were aware of the interconnectedness between team functioning and the quality of care that they experienced. Notably, nurses were often perceived as too busy to be patient advocates. Conclusion: The aspects of care identified by consumers as patient advocacy mirror competencies and standards of professional nursing practice. If patient advocacy in nursing is interpreted as a metaphor for these competencies, then no additional training is needed for the role. However, if patient advocacy is a unique concept for the purpose of meeting the unmet needs of patients, then the skill set differs. Care delivery models in which nurses influence interprofessional teams with nursing values, consumer needs, and evidence-based practices highlight patient advocacy as a tool for change.
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Theses for the degree of Doctor of Philosophy (University of Hawaii at Manoa). Nursing (PhD).
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